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Colour atlas of mesothelioma
Book Reviews
410
asthma, with much repetition. Of the two remaining chapters I felt that separate consideration of bronchodilators in the elderly was rather an artificial distinction, and a single chapter on chronic bronchitis and emphysema, although quite correctly considered, seemed rather isolated in a book that otherwise dealt entirely with asthma. The variety ofauthors in the book will inevitably result in differing appeals to individual readers. I particularly enjoyed the chapters on mechanisms of bronchoconstriction (by Holgate) and exercise-induced asthma (by Godfrey), which were both readable and informative, but found some others ‘whetting the appetite’ though falling short on detail. I confess I was a little irritated to find on several occasions that authors extended their comment beyond consideration of bronchodilators to give (sometimes dogmatic) advice on the general management ofpatients with asthma. Generally authors gave fair review of other workers’ data, but there were occasional inaccuracies (I may be oversensitive having found myself misquoted twice on one page in the chapter on nocturnal asthma), and most chapters were well referenced. Review of this book would be incomplete without observing that there is a surprising frequency of use of drug trade names which is both unfortunate and unnecessary. Bronchodilator Therapy largely reflects the British approach to asthma management and American readers may be surprised by some of the negative comments about methylxanthines. Nevertheless the presentation of the book is so good and the standard sufficiently high that it should prove a welcome addition to the bookshelves of chest physicians generally. Andrew
P. Greening
Disease S. Roberts, R. J. Hay, D. W. R. MacKenzie New York: Marcel Dekker. 1984. 1st edition. Pp. 264. Price $49.75 (US); $59.50 (all others) A Clinician’s
Guide
to Fungal
The aim of this book is clearly set out in the Editor’s introduction and is to give a clear overview of fungal disease for the referring clinician, whatever his speciality. As a reference book, it is easy to read, brief, but clear and concise: the chapters follow a logical sequence and perhaps the most useful chap-
ters for clinical application are those covering treatment and diagnosis. The line drawings are excellent but I doubt if the black and white prints ofindividual mycoses will add very much or will be remembered. The biggest disappointment for a chest physician would be the inconsistencies in the section on respiratory allergy, where there are oddities and errors. Intrinsic asthma is not synonymous with bronchopulmonary aspergillosis; salbutamol or Intal ‘taken by insufflation’ is a curious phrase. The paucity of references is deliberate, but some are more than two decades old and probably not obtainable. The biggest drawback is the price, w-hich is prohibitive for the individual and for the undergraduate at whom it is also aimed, and I think a library committee would look closely at competitors before purchase. A. K. Webb
Colour
Atlas
of Mesothelioma
J. S. P. Jones, C. Lund and H. T. Planteydt Lancaster: MTP Press Ltd. 1985. 1st edition. Pp. 201. Price E49.00 This atlas has been written primarily for pathologists but it will no doubt be of interest to chest physicians and surgeons. The first 47 pages consist of a number of sections dealing with the normal mesothelium, and the pathology of malignant mesothelioma and its clinical features, aetiology and epidemiology. Reference is also made to the work of mesothelioma panels, and a list of the panels in various countries is included. The rest of the book consists of numerous colour plates of the gross appearance, histology and cytology of malignant mesothelioma, together with a series of case reports. This is followed by further illustrations and descriptions of benign localized pleural mesothelioma, adenomatoid mesothelioma and mesotheliomas of the tunica vaginalis and A-V node. The text is well laid out and factual, and each section is followed by a short but adequate list of references. There is, however, very little discussion of the differential diagnosis of biopsy specimens, and the problems encountered in such material are hardly mentioned. The colour plates are of high quality, hut one is doubtful about the practical value of so many. Although
Book Reviews malignant mesothelioma is an unusual tumour, it is by no means rare. It is well documented, and most pathologists are familiar with its appearances at first hand, so almost 30 gross photographs and over 100 photomicrographs are hardly necessary. And again from the practical point of view, there is insufficient emphasis on differential diagnosis. Illustrations of reactive pleura and secondary pleural tumours would have been of infinitely more use in an atlas of this nature. The relatively high price of E49 is undoubtedly due to the large number of colour plates. The text, in so far as it goes, is helpful and informative, but somehow the authors have missed their direction in a veritable forest of illustrations. A smaller number of good black and white photographs would have reduced the cost ofthis book, and more attention to diagnostic pitfalls would have given it a much wider appeal. C. W. Edwards
Hutchinson’s
Clinical
Methods
Michael Swash & Stuart Mason Eastbourne, Sussex: Bailliere Tindall. 18th edition. Pp. 502. price L5.50
1984.
The best part of this book, as far as the respiratory system is concerned, is undoubtedly the Iirst chapter ‘Doctor and Patient’. This excellent chapter describes in an interesting and well written way, the humane and sympathetic approach required by a good doctor. It emphasizes the importance of listening to and looking at the patient as a whole, and it stresses the importance that patients and their doctors should give to non-organic causes and contributions to the patient’s physical symptoms-‘The majority of patients consult a doctor about bodily disorders that express mental distress.’ My only- quibble with this section of the book, as far as the respiratory system is concerned, relates to the lack of emphasis given to the importance of nocturnal respiratory symptoms, or an increase in these symptoms at night, in the recognition of asthma, a point which should be emphasized in all teaching about this common disease. Chapter 8 on ‘The Respiratory System’ is an extremely disappointing 25 pages. There is
really no excuse for the confusingly and poorly labelled diagrams of the bronchial anatomy, and who now calls the apical segment of the lower lobe, ‘the dorsal lobe’? Scoliosis means twisting of the vertebral column, and not lateral bending. Is an increased quantity of carbon dioxide in the blood ever the cause of hyperventilation, apart from during experimental CO? breathing or rebreathing, in a physiology laboratory? When talking about inspection of the movements ofthe chest, is it not important to describe the characteristic features of patients with psychogenic breathlessness, or hyperventilation syndrome? Although chest expansion can be measured with a tape measure round the chest, and may still be required for insurance medical examinations, is it really the best method of examining chest expansion in 1985? How many of us still find percussing cardiac dullness relevant, and ifa sign is ‘absent in many cases of pneumothorax’, why take up a paragraph to describe it (the coin sign)? Auscultation using the unaided ear remains important, and is not mentioned at all, as it is the best method of detecting stridor of which I could not find a mention anywhere. In my experience bronchial breathing is not ‘very rare’ over pleural effusion, but not uncommon, and is a frequent cause of diagnostic difficulty in doctors not trained to expect it. Having started promisingly on added sounds by reducing them to wheezes and crackles, the author turns in the next paragraph to rhonchi, both sibilant and sonorous. Nowhere in this account is there a clear description of the way in which these two sounds, w-heezes and crackles, are generated, and there is no mention of the inspiratory squeak or squawk now recognized to occur in many conditions in which the bronchioles become narrowed. Though feeling slightly guilty admitting this, I have not used tactile vocal fremitus, bronchophony, or whispering pectoriloquy for over a decade. I do obviously believe that physical examination of the respiratory system is important even in these days of readily available radiographs and simple pulmonary function tests because, despite the availability of those investigations, most doctors do not practice in a hospital and for those who do there are times, particularly in the seriously ill patient, when good quality radiographs are impossible. One does have to teach and learn good physical examination of the chest, but surely now these
410
asthma, with much repetition. Of the two remaining chapters I felt that separate consideration of bronchodilators in the elderly was rather an artificial distinction, and a single chapter on chronic bronchitis and emphysema, although quite correctly considered, seemed rather isolated in a book that otherwise dealt entirely with asthma. The variety ofauthors in the book will inevitably result in differing appeals to individual readers. I particularly enjoyed the chapters on mechanisms of bronchoconstriction (by Holgate) and exercise-induced asthma (by Godfrey), which were both readable and informative, but found some others ‘whetting the appetite’ though falling short on detail. I confess I was a little irritated to find on several occasions that authors extended their comment beyond consideration of bronchodilators to give (sometimes dogmatic) advice on the general management ofpatients with asthma. Generally authors gave fair review of other workers’ data, but there were occasional inaccuracies (I may be oversensitive having found myself misquoted twice on one page in the chapter on nocturnal asthma), and most chapters were well referenced. Review of this book would be incomplete without observing that there is a surprising frequency of use of drug trade names which is both unfortunate and unnecessary. Bronchodilator Therapy largely reflects the British approach to asthma management and American readers may be surprised by some of the negative comments about methylxanthines. Nevertheless the presentation of the book is so good and the standard sufficiently high that it should prove a welcome addition to the bookshelves of chest physicians generally. Andrew
P. Greening
Disease S. Roberts, R. J. Hay, D. W. R. MacKenzie New York: Marcel Dekker. 1984. 1st edition. Pp. 264. Price $49.75 (US); $59.50 (all others) A Clinician’s
Guide
to Fungal
The aim of this book is clearly set out in the Editor’s introduction and is to give a clear overview of fungal disease for the referring clinician, whatever his speciality. As a reference book, it is easy to read, brief, but clear and concise: the chapters follow a logical sequence and perhaps the most useful chap-
ters for clinical application are those covering treatment and diagnosis. The line drawings are excellent but I doubt if the black and white prints ofindividual mycoses will add very much or will be remembered. The biggest disappointment for a chest physician would be the inconsistencies in the section on respiratory allergy, where there are oddities and errors. Intrinsic asthma is not synonymous with bronchopulmonary aspergillosis; salbutamol or Intal ‘taken by insufflation’ is a curious phrase. The paucity of references is deliberate, but some are more than two decades old and probably not obtainable. The biggest drawback is the price, w-hich is prohibitive for the individual and for the undergraduate at whom it is also aimed, and I think a library committee would look closely at competitors before purchase. A. K. Webb
Colour
Atlas
of Mesothelioma
J. S. P. Jones, C. Lund and H. T. Planteydt Lancaster: MTP Press Ltd. 1985. 1st edition. Pp. 201. Price E49.00 This atlas has been written primarily for pathologists but it will no doubt be of interest to chest physicians and surgeons. The first 47 pages consist of a number of sections dealing with the normal mesothelium, and the pathology of malignant mesothelioma and its clinical features, aetiology and epidemiology. Reference is also made to the work of mesothelioma panels, and a list of the panels in various countries is included. The rest of the book consists of numerous colour plates of the gross appearance, histology and cytology of malignant mesothelioma, together with a series of case reports. This is followed by further illustrations and descriptions of benign localized pleural mesothelioma, adenomatoid mesothelioma and mesotheliomas of the tunica vaginalis and A-V node. The text is well laid out and factual, and each section is followed by a short but adequate list of references. There is, however, very little discussion of the differential diagnosis of biopsy specimens, and the problems encountered in such material are hardly mentioned. The colour plates are of high quality, hut one is doubtful about the practical value of so many. Although
Book Reviews malignant mesothelioma is an unusual tumour, it is by no means rare. It is well documented, and most pathologists are familiar with its appearances at first hand, so almost 30 gross photographs and over 100 photomicrographs are hardly necessary. And again from the practical point of view, there is insufficient emphasis on differential diagnosis. Illustrations of reactive pleura and secondary pleural tumours would have been of infinitely more use in an atlas of this nature. The relatively high price of E49 is undoubtedly due to the large number of colour plates. The text, in so far as it goes, is helpful and informative, but somehow the authors have missed their direction in a veritable forest of illustrations. A smaller number of good black and white photographs would have reduced the cost ofthis book, and more attention to diagnostic pitfalls would have given it a much wider appeal. C. W. Edwards
Hutchinson’s
Clinical
Methods
Michael Swash & Stuart Mason Eastbourne, Sussex: Bailliere Tindall. 18th edition. Pp. 502. price L5.50
1984.
The best part of this book, as far as the respiratory system is concerned, is undoubtedly the Iirst chapter ‘Doctor and Patient’. This excellent chapter describes in an interesting and well written way, the humane and sympathetic approach required by a good doctor. It emphasizes the importance of listening to and looking at the patient as a whole, and it stresses the importance that patients and their doctors should give to non-organic causes and contributions to the patient’s physical symptoms-‘The majority of patients consult a doctor about bodily disorders that express mental distress.’ My only- quibble with this section of the book, as far as the respiratory system is concerned, relates to the lack of emphasis given to the importance of nocturnal respiratory symptoms, or an increase in these symptoms at night, in the recognition of asthma, a point which should be emphasized in all teaching about this common disease. Chapter 8 on ‘The Respiratory System’ is an extremely disappointing 25 pages. There is
really no excuse for the confusingly and poorly labelled diagrams of the bronchial anatomy, and who now calls the apical segment of the lower lobe, ‘the dorsal lobe’? Scoliosis means twisting of the vertebral column, and not lateral bending. Is an increased quantity of carbon dioxide in the blood ever the cause of hyperventilation, apart from during experimental CO? breathing or rebreathing, in a physiology laboratory? When talking about inspection of the movements ofthe chest, is it not important to describe the characteristic features of patients with psychogenic breathlessness, or hyperventilation syndrome? Although chest expansion can be measured with a tape measure round the chest, and may still be required for insurance medical examinations, is it really the best method of examining chest expansion in 1985? How many of us still find percussing cardiac dullness relevant, and ifa sign is ‘absent in many cases of pneumothorax’, why take up a paragraph to describe it (the coin sign)? Auscultation using the unaided ear remains important, and is not mentioned at all, as it is the best method of detecting stridor of which I could not find a mention anywhere. In my experience bronchial breathing is not ‘very rare’ over pleural effusion, but not uncommon, and is a frequent cause of diagnostic difficulty in doctors not trained to expect it. Having started promisingly on added sounds by reducing them to wheezes and crackles, the author turns in the next paragraph to rhonchi, both sibilant and sonorous. Nowhere in this account is there a clear description of the way in which these two sounds, w-heezes and crackles, are generated, and there is no mention of the inspiratory squeak or squawk now recognized to occur in many conditions in which the bronchioles become narrowed. Though feeling slightly guilty admitting this, I have not used tactile vocal fremitus, bronchophony, or whispering pectoriloquy for over a decade. I do obviously believe that physical examination of the respiratory system is important even in these days of readily available radiographs and simple pulmonary function tests because, despite the availability of those investigations, most doctors do not practice in a hospital and for those who do there are times, particularly in the seriously ill patient, when good quality radiographs are impossible. One does have to teach and learn good physical examination of the chest, but surely now these